There are many complications of thrombocytosis, what should I do?

Middle-aged and elderly people are the main incidence of thrombocytosis. The initial symptoms are not typical, and there is no feeling at all. However, as the number of platelets increases abnormally, the patients will suffer serious bleeding or thrombosis. Therefore, thrombocytopenia seriously endangers the health and even life span of patients, requiring treatment. Primary thrombocytosis is a myeloproliferative disease that occurs in bone marrow stem cells. Secondary thrombocytosis is commonly caused by inflammation and tumor diseases. Symptoms such as fatigue, bleeding, anemia, numbness of hands and feet, and splenomegaly are common clinical manifestations of thrombocytosis in the early stage. |How is thrombocytosis treated? |Most patients or hospitals use oral hydroxyurea or intramuscular interferon for long-term maintenance treatment after bone puncture or genetic testing. When the platelet rises in an uncontrollable state, it will increase hydroxyurea or other bone marrow suppression drug. During medication, the platelet count was well controlled, but the side effects of these medications were ignored. Chemotherapy drugs have always been known as “double-edged swords”. While reducing abnormal blood cells, they also have adverse effects on normal human functions. In addition, these drugs cannot prevent the disease from turning into leukemia, myelofibrosis and other malignant blood diseases. In this regard, hematology experts recommend that while effectively controlling the condition, patients should also join Chinese medicine treatment in a timely manner, and treat the symptoms according to the syndrome, so as to effectively deal with the various complications and hazards of thrombocytosis! For more patient communication help, please follow the WeChat public account [thrombocytosis patients association] xxbzd999

Prolonged dizziness, fatigue, be careful of thrombocytosis!

   dizziness, fatigue, do you think it is anemia? It may also be thrombocytosis. The prevalence of essential thrombocythemia in my country is 2.5/100,000. People aged 50-70 are prone to get this disease. The prevalence of secondary thrombocythemia in my country is not very clear.   Patients with mild thrombocythemia have only dizziness and fatigue symptoms; severe patients may have bleeding and thrombosis.   Bleeding is often spontaneous and can occur repeatedly. It is seen in 2/3 of the illness. It is common in gastrointestinal bleeding. There may also be epistaxis, bleeding gums, hematuria, and ecchymosis of the skin and mucous membranes. The incidence of thrombosis is less than bleeding. According to statistics in China, 30% have arterial or venous thrombosis. After limb vascular embolism, limb numbness, pain, and even gangrene may be manifested, as well as erythematous limb pain. Embolism of spleen and mesenteric vessels can cause abdominal pain and vomiting. Embolism of lung, brain and kidney causes corresponding clinical symptoms. Splenomegaly accounts for 80%, usually mild to moderate. A few patients have hepatomegaly.   For patients with secondary thrombocytosis, chronic infections or autoimmune diseases should be actively treated. Iron-deficiency patients receive iron supplementation in time to correct anemia as soon as possible. Tumor patients need to regularly check blood routine, biochemical and related imaging indicators, and timely surgery or active treatment through radiotherapy, chemotherapy and other methods. After splenectomy, the platelet count is checked regularly.   Patients with essential thrombocythemia must quit smoking strictly to reduce the risk of cardiovascular disease. For unchangeable risk factors, people over the age of 50 who relapse should have regular physical examinations at least once a year to monitor blood routine and coagulation function, which will help prevent or prevent diseases.

Be alert: the platelets are too high and dangerous!

The platelet count is too high. This phenomenon is very common after routine blood tests, but when it is slightly high, we will not take it seriously. Once we find that the platelet count is too high, exceeding 500, 600, or even 1000, we must It has attracted enough attention! What does high platelet mean? Abnormally high platelet counts are common in blood diseases, especially myeloproliferative diseases. If treatment is not taken in time, and the disease is allowed to progress, it is easy to cause bleeding or thrombosis to make the patient worry about life. What happens if the platelets are high? The apparently high platelet count can be considered as essential thrombocytosis. Essential thrombocythemia is a myeloproliferative disease of unknown cause, which mostly occurs in middle-aged and elderly people over 40 years old, especially those between 50 and 60 years old. Therefore, if the physical examination finds that the platelet count is too high, further examination must be done in time. What are the hazards of thrombocytosis? About 20% of patients, especially young patients, are asymptomatic at the time of onset, and occasionally diagnosed with thrombocytosis and further examination of splenomegaly. One-third of patients present with functional or vasomotor symptoms including vascular headache, dizziness, blurred vision, burning pain in the palms and soles, and peripheral numbness. 80% of patients may have unexplained bleeding and thrombosis and seek medical treatment. Bleeding is often spontaneous and can occur repeatedly. It is common with gastrointestinal bleeding, but also bleeding from the nose, gums, hematuria, and respiratory tract bleeding. Among them, the incidence of thrombosis is less than that of bleeding. For more patient communication help, please pay attention to the WeChat public account [thrombocytosis patients association] xxbzd999

Let the platelets increase to thousands, what will happen in the end?

 Nowadays, more and more elderly people are suffering from blood clots. Elderly patients with thrombocytosis should be more alert to the occurrence of thrombosis. Essential thrombocythemia is likely to be caused by the excessive proliferation of bone marrow aggregate cells. This disease has a relatively low incidence and is a chronic benign hyperplasia. It must be used to reduce platelets under the guidance of a doctor. If it is not treated in time, it may cause the formation of blood clots, which may cause headaches and dizziness. Essential thrombocytosis is likely to be caused by a long time of improper diet and excessive exertion, and a certain kind of inflammation in the body. Under the guidance of a doctor, some anti-platelet drugs and venous bleeding should be used. It requires long-term medication to prevent a significant increase in platelets.   Pathological platelet hyperplasia is often caused by acute or chronic infection, tuberculosis inflammation, spleen resection and malignant tumors. Therefore, it is more serious than the primary one. A small number of patients will also induce other diseases. Excessive platelet increase will increase the thickness of the blood. Usually, if there is a heart obstruction, it may induce other diseases and be life-threatening.    Thrombosis is easy to see in elderly patients, but less common in young patients. Arteries and veins can occur, but arterial thrombosis is more common. Cerebral blood vessels, splenic blood vessels, mesenteric blood vessels, and finger and toe blood vessels are the most common sites. Thrombosis generally occurs in small blood vessels, but can also occur in large blood vessels. Blockage of blood vessels in fingers or toes can cause local pain, burning, redness and heat, and can develop into bruising or necrosis. Cerebrovascular thrombosis often causes neurological symptoms. Temporary cerebral ischemia, visual disturbance, sensory disturbance, headache, dizziness, and insomnia are common. Cerebrovascular accidents also occur. Both pulmonary thrombosis and myocardial infarction occurred.   Therefore, early treatment is needed according to different causes. The usual treatment is to take aspirin. Bone marrow suppression drugs, commonly used drugs include hydroxyurea and busulfan, which are used to inhibit the abnormal proliferation of bone marrow. Interferon can inhibit cell proliferation in essential thrombocythemia.

What are the treatments for essential thrombocythemia?

Blood is a red, opaque, viscous liquid that flows through human blood vessels and heart. Blood is composed of plasma and blood cells. Blood cells include red blood cells, white blood cells, and platelets. Platelets are mainly involved in hemostasis and thrombus formation. Blood stores human health information. Many diseases require blood tests. Some people find that the number of platelets increases significantly during the blood test. In clinical practice, this condition is usually called thrombocytosis. &nbsp.&nbsp. Primary thrombocythemia (ET) patients are more common in middle-aged and elderly people over 40 years old. It is a type of myeloproliferative disease. Megakaryocytes in the bone marrow of patients are abnormally proliferated, and the platelet count is significantly increased. And there is a tendency to spontaneous bleeding and thrombosis. More than half of the patients are accompanied by splenomegaly, pulmonary embolism and myocardial infarction, and cerebral infarction can be life-threatening. &nbsp.&nbsp.So how to treat thrombocytosis? Primary thrombocytosis, there is still no specific treatment drug or method, it is one of the clinically difficult diseases. The main purpose of treatment is to reduce the number of platelets, prognose the occurrence of thrombosis and bleeding, and reduce disease progression, which is symptomatic The treatment methods are as follows:&nbsp.&nbsp.1. Decreasing cell therapy: use myelosuppressive drugs, especially for patients with platelets higher than 1000, including drugs such as hydroxyurea and interferon. Compared with the simple down-cell effect of hydroxyurea, interferon can inhibit megakaryocyte production and shorten the life span of platelets, but both can relapse after stopping the drug. &nbsp.&nbsp.2. Platelet separation quickly reduces the number of platelets and improves symptoms. It is often used for gastrointestinal bleeding, pregnancy and childbirth, and before elective surgery. &nbsp.&nbsp.3. General treatment using dipyridamole, aspirin, and indomethacin can prevent platelet aggregation. Patients with thrombosis should use heparin or double coumarin anticoagulants. Spleen cutting is contraindicated. &nbsp.&nbsp.4. JAK2 inhibitor-Luctinib (Jegwei): Since 2005, acquired mutations and primary genes of JAK2V617F, CALR, JAK2 exon 12 and MPLW515L/K have been discovered successively The occurrence of thrombocythemia is closely related. The mutation of the above-mentioned genes activates its downstream signaling pathways to cause excessive platelet proliferation, resulting in a series of clinical manifestations such as thrombocytosis, bleeding, thrombosis, and splenomegaly. Regarding this discovery, the JAK2 kinase (JAK2V617F) inhibitor-Rucotinib (Jegwei) has been clinically used to treat patients with essential thrombocythemia with myelofibrosis. Luctinib (Jegwei) is the world’s first approved JAK inhibitor. Current studies believe that the inhibitor has good curative effects and is a specific therapeutic drug. It can not only control the number of platelets, but also delay bone marrow fibrosis, shrink the spleen, and improve physical symptoms (such as fatigue, anorexia, sweating, anxiety, etc.) ). Although Jegway cannot cure ET, with the development of science, it is believed that in the future, more and more specific targeted therapy drugs will be developed and may be put into clinical use.

Attention! Myeloma has too high plasma cells, these Chinese medicines are forbidden…

Clinically, for some severe patients in the advanced stage of multiple myeloma, tumor cell plasma cells can reach as high as 85%, and immunoglobulins (IgM, IgA, IgG, etc.) can reach more than 1,000. Attention! Myeloma has too high plasma cells, these Chinese medicines are forbidden! In this regard, related medicine pointed out that the pathological increase of immunoglobulin does not necessarily involve cooling blood, detoxification, and softening and dispelling knots. For example, these traditional Chinese medicines: Huang Yazi, Shanzi Mushroom, Southern Star, Scutellaria barbata, Oldenlandia diffusa, Prunella vulgaris and so on. Even the waves use five poisons such as whole insects, centipedes, black snakes, toads, and Tianlong, which are called poisons to fight poisons. The poison has not gone, and the righteousness has disappeared, and many patients are in desperation. Excerpted from the comments of Chinese medicine practitioners-understanding the characteristics of multiple myeloma lesions of myeloma-the corresponding understanding is that the body’s immune and regulatory functions are extremely low or extremely disordered. As a result, tumor suppressor genes in vivo lose their ability to monitor proto-oncogenes, leading to a decrease in cell differentiation. This poorly differentiated cell has unlimited growth, leading to an extreme increase in plasma cells or a pathological increase in immunoglobulin. Traditional Chinese medicine has special significance in its treatment. The targeted application can complement Western medicine to treat multiple myeloma. It protects, enhances, and activates the immune system as a breakthrough-to extend and promote the survival of myeloma patients, and at the same time The premise guarantees a considerable quality of life. To learn more about “disease knowledge” or “myeloma patient group exchange” and other WeChat search public number: jjgs120

What are the lifestyle-related risk factors for breast cancer?

   Breast cancer risk factors related to lifestyle include drinking, being overweight or obese, not exercising, not having children, not breastfeeding, contraception, postmenopausal hormone therapy, and breast augmentation. Drinking alcohol can increase the risk of breast cancer in women. The more alcohol you drink, the higher the risk of disease: 1. Compared with non-drinkers, women who consume more than 3 bottles of alcoholic beverages a day have a 1.5 times higher risk of breast cancer. 2. Compared with non-drinkers, women who consume 2-3 bottles of alcoholic beverages a day have a 30% increased risk of breast cancer;   3. Compared with non-drinkers, women who consume 1 bottle of alcoholic beverages a day are at risk of breast cancer A slight increase;   4. Compared with women who do not drink alcohol, women who drink alcohol every day have an increased risk of breast cancer by 7%-9%.  Why is overweight or obesity increasing the risk of breast cancer in postmenopausal women?  Estrogen plays a key role in the occurrence of breast cancer. The more estrogen a woman produces in her lifetime, the higher her probability of breast cancer.   The estrogen of premenopausal women is mostly produced by the ovaries, but after menopause, the ovaries stop secreting estrogen. The main source of estrogen is the estrogen converted by aromatase in fat. Therefore, having more fat tissue will increase your estrogen content, thereby increasing your risk of breast cancer. And being overweight will increase the concentration of insulin in the blood, which is also related to the increased risk of breast cancer. Inactivity and lack of physical exercise, such as a sedentary lifestyle, can increase the risk of breast cancer; vigorous exercise during adolescence may reduce the lifetime risk of breast cancer; as an adult, moderate physical activity can reduce the risk of breast cancer risk. Exercise may affect the content of female estrogen and progesterone.   It can reduce the efficiency of converting body fat into estrogen in postmenopausal women. In addition, exercise can also improve your immune function. Therefore, exercise can reduce the risk of breast cancer. Women who have not given birth, are not breastfeeding 1. Women who have never been pregnant or have their first child after the age of 30 are about twice as likely to develop breast cancer as women who have given birth before the age of 30;   2, multiple pregnancies and Pregnancy at a young age can reduce the risk of breast cancer. Each child will reduce the risk of breast cancer in women by 7%;   3. Women who choose breastfeeding can reduce their risk of breast cancer, and breastfeeding every 12 months reduces women’s risk by 4.3% Risk of breast cancer. Contraception, postmenopausal hormone therapy, breast augmentation Some contraceptive methods use hormones, which may increase the risk of breast cancer: Oral contraceptives: Compared with those who have never used oral contraceptives, women with oral contraceptives have a slight risk of breast cancer Increase; contraceptive implants, intrauterine devices, skin patches, vaginal rings: these forms of contraception all use hormones, and theoretically they will also promote the growth of breast cancer.   Postmenopausal hormone therapy: Previously hormone replacement therapy (using estrogen and progesterone) was used to relieve menopausal symptoms and prevent osteoporosis. But studies have found that combined use of estrogen and progesterone in postmenopausal women can increase the risk of breast cancer by 25%.   Breast augmentation: Certain types of breast implants are associated with a rare cancer called anaplastic large cell lymphoma (ALCL).

Cheng Yahui popular science: causes and symptoms of uterine fibroids

Many women who have been diagnosed with uterine fibroids due to infertility are often very confused and come to ask the doctor: “I don’t have any bad habits or hobbies? Why do fibroids grow in my body?” Speaking of uterine fibroids, I believe everyone is no stranger. According to statistics, the incidence of uterine fibroids in women of childbearing age is >30%, which is a common benign tumor of female reproductive organs. Although the exact cause of uterine fibroids is still unclear, clinical studies have pointed out these related factors: Hormones: In each menstrual cycle preparing for pregnancy, estrogen plays a key role in stimulating endometrial development. This hormone obviously promotes the growth of uterine fibroids. Heredity: Uterine fibroids seem to be inherited in the family. Obesity: Women who are obese due to obesity have a two to three times higher risk of uterine fibroids, which is closely related to the higher rate of circulating estrogen and its production. If the fibroids stay there quietly, it’s fine, but it’s really tangled to be combined with infertility. Uterus-the growth of fibroids Uterine fibroids can grow anywhere in the uterus, but the incidence of fibroids is different in different locations. The female uterus is a hollow reproductive organ with a cavity. The uterine cavity is a triangular cavity with a wide upper part and a narrow lower part. The uterus is like a balloon, with a sphere (uterine body) and an opening (cervix). The uterine body and the neck are called the “isthmus”. Among them, fibroids in the uterus account for about 90%, and fibroids in the cervix and isthmus account for less than 10%. The uterine wall is like the outer layer of a balloon, which is divided into three layers: serosa, muscle layer and mucosa (endometrium) from the outside to the inside. Fibroids may grow in every layer: intermural fibroids are the most common, accounting for 60% to 70%. Subserosal fibroids account for about 20%. Submucosal fibroids account for 10%~15% (see figure below). Uterine fibroids can be multiple, or multiple types of fibroids can grow on the same uterus. If there are more than two fibroids, we will call it “multiple uterine fibroids.” Fibroids tend to grow slowly, and there are no physical reactions or symptoms in the early stage, and they are easily overlooked. Most women find fibroids accidentally during physical examinations, and some women find fibroids until they have grown to cause symptoms and go to the hospital for examination. Uterine fibroids-what are the symptoms? There are many women with uterine fibroids, most of whom have no obvious discomfort and are often found unintentionally during physical examinations. The symptoms and severity are mainly related to the location, size, number, and presence or absence of fibroids. The main symptoms are: heavy menstrual flow, long menstrual period, irregular menstruation, more leucorrhea, and masses in the lower abdomen. 1. Increased menstrual flow and prolonged menstrual period: This is the most common symptom of uterine fibroids. Large intramural fibroids and submucosal fibroids generally experience increased menstruation. This type of fibroids enlarges the uterine cavity and increases the bleeding endometrial area. It also affects uterine contraction, which is not conducive to hemostasis; fibroids can also squeeze nearby veins and cause vascular congestion and expansion, so menstrual flow increases and menstrual periods are prolonged. Long-term increased menstrual flow can lead to anemia. 2. Lower abdominal mass: Uterine fibroids grow beyond the pelvic cavity, and the patient can feel the mass in the lower abdomen. Submucosal fibroids may protrude from the cervix and be seen in the vagina. 3. Increased leucorrhea: Large intramural fibroids and submucosal fibroids increase the area of ​​the uterine cavity, increase the secretion of endometrial glands, and pelvic congestion, which can increase leucorrhea. When submucosal fibroids are accompanied by infection or necrosis, they are often bloody, heavy, and vaginal fluid. 4. Compression symptoms: The front of the uterus is the bladder. When the uterine fibroids are large, the bladder may be compressed, causing frequent urination. Fibroids in the cervix may compress the urethra and cause difficulty in urination. The back of the uterus is the rectum, and fibroids in the posterior wall can cause lower abdominal distension and constipation.

The new drug for polycythemia vera, the two-year evaluation result of alfa-2b is “released”!

Polycythemia vera (PV) is a clonal chronic myeloproliferative disease of hematopoietic stem cells. PV starts insidiously and progresses slowly, and usually goes through the following two stages of progression: ① Proliferation or polycythemia phase-often with erythrocytosis; ② Late erythrocytosis-manifested as pancytopenia, extramedullary hematopoiesis, liver and spleen Large, hypersplenism and bone marrow fibrosis. The new drug for polycythemia vera, the two-year evaluation result of alfa-2b is “released”! What kind of medicine is this? This drug is a new single-isomer long-acting peginterferon in the clinical development stage for the treatment of patients with polycythemia vera (PV). Last year, in 2018, there was a 36-month progress result of this drug, which concluded that this drug has a good control effect and good tolerability. It makes medical practitioners more convinced that this drug will be a new generation of “interferon”. The beneficial result of this drug in the treatment of true red (the result of two-year evaluation) is released: • It can reflect the advantages of better available therapies; • It can achieve completeness Blood reaction rate and long-term clinical and blood reaction rate; • It reflects the safety and drug resistance of the two-year period; • It has further proved the ability to relieve the disease; … I hope that the popularization of new drugs can really benefit patients, Let every patient see the onset of illness! For more patient communication help, please follow the WeChat public account [True Red Patient Club] zkxy120

Why do other people’s platelets are normal, but mine is inexplicably higher?

Why do other people’s platelets are normal, but mine is inexplicably higher? Many patient doctors tell you that they suspect essential thrombocythemia or other blood diseases. They always feel a little unbelievable: how can you get sick if you are in good health? ! In fact, there are many causes of thrombocytosis, such as anemia, heredity, inflammatory infection, blood stasis, platelet function defects, accelerated platelet production, etc., and the possible harms that may occur in patients with thrombocytosis include bleeding, thrombosis, liver and spleen In severe cases, the patient will have life worry. Learn about the analysis of the main causes of thrombocytosis: such as iron deficiency anemia, splenectomy, disseminated tumors, acute blood loss, hemolysis, infection and inflammation, surgery and trauma, and certain drugs. The occurrence may be caused by platelets. It may be related to abnormal distribution. If there are patients with essential thrombocytosis in the patient’s family, then another cause of essential thrombocytosis is genetic factors. Blood stasis is the understanding of the cause of this disease in Chinese medicine, which is mainly caused by stagnation of qi, deficiency of qi, deficiency of yin, stagnation of the liver, and cold coagulation. Therefore, we must pay special attention to “Any congestion, it is necessary to remove blood stasis. The functional defects of platelets degrade its adhesion and aggregation functions, but also reduce the third factor of platelets, reduce and release serotonin. Abnormal function. There are also some patients with abnormal blood coagulation mechanism and increased capillary fragility. The cause of essential thrombocytosis may be due to the existence of plasma platelet stimulation, which causes excessive platelet production. In addition, some patients (such as exercise Later) thrombocytosis is often caused by the excessive release of platelets in the spleen, lung and other storage pools. This is mostly caused by physiological factors and has nothing to do with the original rational thrombocytosis disease. More patient communication and help can follow WeChat Public Account【Thrombocytosis Patients Association】xxbzd999

[Doctor-patient question and answer] What is the safest level for thrombocytosis to recover?

Patient question: Hello doctor, I was diagnosed with thrombocytosis not long ago. In the last routine blood test, the platelet count was 1200. I have been taking hydroxyurea treatment. I heard that thrombocytosis can cause blood clots. Is this true? I am only 30 years old this year, will I have blood clots? Doctor’s answer: The normal range of platelet values ​​is 100~300X10^9/L, and 1200 is a serious condition, and must be treated actively. Thrombocytosis is caused by abnormal malignant proliferation of bone marrow, and platelet function is insufficiency, and there is a tendency to bleeding. In addition, thrombocytosis can cause the blood to be sticky, easy to agglomerate, and there is a risk of thrombosis. Thromboembolism is the first cause of death in thrombocytosis. The formation of thrombus is not determined by age. The higher the platelet count, the greater the risk of thrombus formation. It’s just that for middle-aged and elderly patients, the risk is a bit greater than that of young people. Thrombosis mostly occurs in arteries, such as cerebral blood vessels, splenic blood vessels, and toe blood vessels. In some patients, thrombosis may also occur in the arteries of the internal organs. Thrombus formation in venous blood vessels is common in renal portal vein, liver, spleen, mesenteric and so on. It can be seen that, in order to achieve a safe level, it is necessary to alleviate the condition as soon as possible, and maintain the platelet value below 400, preferably within the normal range below 300. For more patient communication help, please pay attention to the WeChat public account [thrombocytosis patients association] xxbzd999

Thrombocytosis is harmful, is there any good treatment?

If the condition of thrombocytosis is not effectively controlled, blood clots may form as the condition progresses. If the embolization site appears in the skull, it may cause paralysis and even loss of precious lives. How to effectively treat thrombocytosis? The treatment of thrombocytosis is mainly to reduce the number of platelets in time to reduce the risk of bleeding and thrombosis. Hydroxyurea: It can effectively inhibit bone marrow hematopoiesis and reduce platelet count. It is usually administered orally, which is more convenient. Radionuclide Phosphorus (32P)&nbsp.: Oral or intravenous injection, the recommended first dose is 0.08—0.11MBq, and if necessary, it will be administered again after three months. Application is generally not recommended because of the possibility of inducing leukemia. Interferon: can inhibit megakaryocyte production and shorten the life span of platelets. The recommended dose is 3-5mu/d. Traditional Chinese Medicine: Thrombocytosis belongs to the category of “blood stasis” in traditional Chinese medicine. The treatment is usually based on syndrome differentiation, and the treatment is based on one person and one party. Apheresis/platelet separation: rapidly reduce the number of platelets and improve symptoms. It is often used for gastrointestinal bleeding, pregnancy and childbirth, and before elective surgery. Others: such as dipyridamole, aspirin, and indomethacin can prevent platelet aggregation. Patients with thrombosis should use heparin or double coumarin anticoagulants. In addition to the risk of thrombosis, thrombocytosis also has a bleeding tendency. Therefore, patients must pay attention to their own conditions. If severe discomfort occurs, do not delay, seek medical attention immediately to find out the cause and relieve symptoms of discomfort. For more patient communication help, please pay attention to the WeChat public account [thrombocytosis patients association] xxbzd999

Will thrombocytosis heal itself?

A large number of investigations found that 99 of the 10,000 respondents had platelet counts >400×109/L at the first examination, and only 8 cases showed persistent thrombocytosis during the 8-month reexamination. Therefore, repeated detection of platelet counts The diagnosis of thrombocytosis is very important.   Thrombocytosis is a type of myeloproliferative disease, which generally cannot be cured by itself. In addition to essential thrombocythemia, myeloproliferative diseases also include polycythemia vera, myelofibrosis, chronic myelogenous leukemia and so on. Many other diseases may only manifest as thrombocytosis in the early stage, so in addition to bone puncture, further improvement of bone marrow pathology and chromosomal genetic examination are needed. One is to diagnose the disease, and the other is to judge the prognosis of treatment.   If it is essential thrombocytosis, this disease is a chronic disease, and it is difficult to cure it. Currently, interferon therapy is used, but platelets can only be reduced temporarily. One is that the side effects are large, and the other is that the condition is easy to recur. This kind of chronic disease is best treated with the traditional Chinese medicine therapy that promotes blood circulation and removes blood stasis. With Qinghuang capsule, if the spleen is enlarged and combined with the comprehensive treatment of Ganpixiao Capsule Pill, it can improve the bone marrow hematopoietic function and smoothly reduce platelets.   This disease is an increase in platelets caused by excessive bone marrow proliferation. It is characterized by excessive proliferation of bone marrow megakaryocytes, continuous and significant increase of platelets in peripheral blood, and functional abnormalities, clinical spontaneous blood tendency and or thrombosis, patients often have splenomegaly. Essential thrombocythemia is a chronic neoplastic disease. It controls platelets at a roughly normal level and reduces the chance of progression to myelofibrosis. Regular follow-up visits will result in a very small number of patients developing acute leukemia.

Why do Chinese people have more and more diabetes? Doctor: 5 reasons cannot be ignored

Diabetes is a real disease of wealth. In the past, the incidence of diabetes was high in some “rich countries” in the West. With the gradual improvement of living standards, the incidence of diabetes in my country is still increasing year by year and tends to be younger and younger. According to my country’s epidemiological statistics, there are currently approximately 109.6 million people diagnosed with diabetes in my country who have diabetes. In the past 30 to 40 years, the incidence of diabetes in China has risen sharply. According to epidemiological survey data in different periods, in 1980, the prevalence of diabetes in adults in my country was less than 1%, and in 2005, this proportion reached 5.5%. Three years later, the prevalence of diabetes in my country It rose to 9.7%. In 2013, this value rose further, reaching 10.3%. According to the World Health Organization’s statistics, the total prevalence rate of diabetes among adults is 9.1%. That is to say, since 2008, the prevalence rate of diabetes in my country has exceeded the world average level, and it has been a constant. Gradually rising trend. Why are the Chinese people increasingly more likely to develop diabetes? Today we will analyze several reasons. The pathological cause of diabetes is the disorder in the body’s metabolic utilization of blood sugar, which is usually related to insufficient insulin secretion and insulin resistance in body cells. However, the reasons for insulin resistance, impaired pancreatic islet cell function and other physiological conditions that cause blood glucose metabolism disorders are also closely related to many factors. The increase in age, family genetic factors, etc., are some uncontrollable factors. Some of the factors in diet, exercise, and environment are also important factors that lead to increased blood sugar and eventually develop into diabetes. Therefore, the reason why the incidence of diabetes in Chinese people is increasing. In the case of uncontrollable factors such as factors, the following reasons are also worthy of our consideration and attention. Eating better and better Long-term overnutrition is one of the main causes of diabetes. Excessive dietary intake is the source of excess nutrition. Life and life have gradually improved. Everyone’s life has passed the better. You can eat whatever you want, so a large number of “gluttonous” people with unrestrained diet have appeared. A long-term high-fat, high-sugar, and high-calorie diet will keep the body’s lipid and blood sugar metabolism in a high-load operation process for a long time. The long-term increase in the body’s metabolic burden is like a long-term overloaded machine. One day , There will be a problem with a certain component. This problem may be high blood pressure or high blood uric acid. The occurrence of diabetes is also closely related to long-term high-calorie diet and overnutrition. While moving less and less, eating better and better, more and more people are sedentary. Diet and activity levels are the two most important aspects of maintaining a balanced energy metabolism in the body. However, the current situation is that while everyone is improving their living standards and eating better and better, there are many friends who move less and less. This kind of “movement” does not necessarily have to be exercise, activity, physical labor, and other physical activities. They are all important ways to strengthen physical consumption and improve body energy metabolism. However, due to the gradual development of society, physical labor or There are fewer and fewer active people, but more and more sedentary people. If in daily work, there is no amount of activity, and there is no deliberate strengthening of exercise, it is more likely to cause an imbalance in body energy metabolism , And the imbalance of energy metabolism is the main reason for the disorder of blood glucose metabolism. Therefore, Chinese people eat more and less and move less and less, so the long-term excess energy will eventually lead to the increasing incidence of diabetes year by year. More and more obese people Obesity is an important risk factor leading to diabetes. As the incidence of diabetes increases year by year, in fact, the proportion of obese people in my country is also showing an upward trend year by year. According to my country’s survey data, the proportion of overweight people in my country (BMI greater than 23 but not more than 27.5) in 2000 was 37.4%. The increase was 39.2% in 2005 and 40.7% in 2010. In 2014, the proportion rose to 41.2%; the proportion of obesity (BMI over 27.5) increased from 8.6% in 2000 to 10.3 in 2005

Afraid of high platelets, what are the ways to lower platelets?

Thrombocytosis means that the platelet count in the patient’s peripheral blood is higher than normal. Not only that, patients may also form blood clots and spontaneous bleeding. For older patients with poor physical fitness, when bleeding and thrombosis occur, these will shorten the patient’s survival time to a certain extent, so the enthusiasm for treatment of this disease is emphasized. What methods are used to treat thrombocythemia clinically? The common ones are as follows: 1. Patients can use drugs such as hydroxyurea, interferon, and Marilan to inhibit bone marrow hematopoiesis, reduce the proliferation of hematopoietic stem cells, and reduce platelet counts. 2. Anticoagulant drugs such as aspirin and anagrelide can effectively inhibit platelet aggregation in patients, thereby improving microcirculation disorders and reducing the risk of thrombosis; 3. Blood cell apheresis is effective, rapid and effective through autologous blood collection and reinfusion. It can selectively reduce the number of platelets in the blood of patients; Fourth, patients with thrombocythemia are mostly accompanied by JAK2 gene mutations, so you can choose experimental drugs that target to inhibit JAK2V617F or MPLW515L/K signaling to improve the mutant JAK2 gene. To achieve the purpose of preventing thrombosis and reducing platelets. In Western medicine, the above-mentioned treatment methods are common methods that can help patients with thrombocythemia quickly control their condition. However, long-term medication is often required for patients, which means that patients have to bear certain side effects of drugs. Vigilance-patients are required to be prepared to alleviate side effects and take timely treatments that increase efficiency and reduce toxicity. For more patient communication help, please pay attention to the WeChat public account [thrombocytosis patients association] xxbzd999

Treatment of leukemia is focused on the primary disease

Overview] Leukemia-like reaction is a response of the hematopoietic system after the body is stimulated. It is manifested as a significant increase in the number of peripheral blood white blood cells and the appearance of immature cells, similar to leukemia.  【Diagnosis】  1. Medical history and symptoms   ⑴ Medical history question: Note: ① Whether there are bacterial, fungal and parasitic infections.  ② Whether you have autoimmune diseases&nbsp. (rheumatoid arthritis, sarcoidosis, etc.) and tumor diseases (kidney tumors, leukemia, etc.).  ③Whether to use glucocorticoids, adrenaline, lithium chloride and other drugs.  ④ Whether there is severe burn, crush injury, electric shock injury, poisoning, acute hemolysis or massive blood loss, whether it is in the recovery period of bone marrow suppression, etc.  ⑵Clinical symptoms: Depending on the original disease, corresponding clinical symptoms appear.   2. Physical examination found:    is mainly the corresponding signs of the primary disease.  3. Auxiliary blood test: red blood cells and hemoglobin are normal (except acute hemolysis, massive blood loss and leukemia), and platelet count is normal. The number of white blood cells is significantly increased> 25×109/L, up to 200×109/L, and there are different types of leukemia-like reactions depending on the body’s stimulating factors, which can be granulocytes, monocytes, lymphocytes or eosinophils The proportion of granulocytes increased. Classification shows immature cells. Toxic granules and vacuoles often appear in the cytoplasm of neutrophils.  2. Bone marrow phenomenon: hyperplasia is active or obviously active, most of the original cells are not significantly increased, and there is no abnormal cell morphology of leukemia. The erythroid and megakaryocyte cell lines are normal.  3. Cytochemical staining: neutrophil alkaline phosphatase score was significantly increased.  4.&nbsp. Genetic examination: no Ph1 chromosome.  Four. Differential diagnosis   Leukemia reactions usually have clear incentives, but when the primary disease is relatively hidden, attention should be paid to distinguish it from leukemia.  【Therapeutic measures】  The leukemia reaction itself does not require treatment, and it can recover quickly after the original cause is removed. Therefore, the primary disease should be carefully searched and treated actively.

Glucocorticoids cause leukocytosis

   Glucocorticoids have powerful anti-inflammatory effects, can inhibit inflammation caused by various reasons, and have anti-allergic, anti-shock, anti-toxin, immunosuppressive and antipyretic effects. In the clinical treatment of severe acute infections, glucocorticoids can be used as adjuvant therapy when effective antibacterial drugs are used to treat infections.  The increase in white blood cells after glucocorticoid use is related to the increase in the number of neutrophils caused by white blood cells. Traditional theory believes that glucocorticoids can reduce eosinophils and lymphocytes in the blood; white blood cells are decreased, and leukocytosis is rare. Individual patients who are specific to hormones think that it stimulates the function of bone marrow neutrophils. Produce the biological stress response of increasing the number of white blood cells, causing the adverse reaction of the increase of white blood cells. Hormonal adverse reactions may mislead doctors to believe that the patient’s infection is worsening, so overtime use of adrenal glucocorticoids and the use of more and stronger antibacterial drugs can cause adverse reactions to antibiotics, such as bacterial flora, liver and kidney damage, Thrombocytopenia, central nervous system toxicity, gastrointestinal reactions, allergic reactions, headaches, dizziness, etc., more importantly, may induce bacterial resistance. Overtime use of adrenal glucocorticoids can cause complications in the digestive system: stimulate the secretion of gastric acid and pepsin and inhibit gastric mucus secretion, reduce the resistance of the gastrointestinal mucosa, induce or aggravate gastric and elodenal ulcers, and even cause Gastrointestinal bleeding or perforation induces tuberculosis recurrence, iatrogenic’adrenal hyperfunction, and cardiovascular complications. Disorders of glucose metabolism, osteoporosis, etc., have caused a waste of medical resources.   Therefore, we remind the majority of clinical authors that the increase in white blood cell counts after the application of adrenal glucocorticoid may be an adverse reaction of adrenal glucocorticoid, which must be analyzed in detail.

What is the oral dose of hydroxyurea for thrombocytosis?

Essential thrombocythemia is a myeloproliferative disease. Because the platelet count in the peripheral blood increases, the platelets easily aggregate to form thrombus, which endangers the life of the patient. One of the first-choice drugs for the treatment of thrombocythemia in clinical practice is hydroxyurea, which will be analyzed below. What is the oral dose of hydroxyurea for thrombocytosis? Hydroxyurea is usually taken by mouth, usually 0.5g at a time, 1~1.5g a day. (Patients should pay attention to placing the medicine in a dark place, shading and keeping it tightly closed when it is not necessary to take the medicine.) During the period of taking this medicine in patients with thrombocytosis, the patient should regularly check the blood picture and observe the treatment effect. Why can hydroxyurea treat essential thrombocythemia? Essential thrombocythemia is a myeloproliferative disease. Hydroxyurea tablets are a nucleoside diphosphate reductase inhibitor. The use of hydroxyurea therapy can effectively inhibit bone marrow hyperplasia, selectively hinder DNA synthesis, and effectively reduce platelet count, so as to achieve the purpose of treatment. Although it has certain therapeutic significance, taking hydroxyurea is mainly the effect of drug control, and the development and outcome of ET cannot be avoided. In addition, it also brings side effects-such as: black nails, dizziness, hair loss, headache, abdominal pain and discomfort. Observation and follow-up need to be done. When adverse reactions occur, it is necessary to actively use conditioning drugs to help alleviate side effects. There are oral and intravenous medications for hydroxyurea, but there is no fixed dosage for how to take it. Because each patient’s individual condition is different, the medication tolerance is also different, you should consult a doctor and follow the doctor’s advice to take it carefully. For more patient communication help, please pay attention to the WeChat public account [thrombocytosis patients association] xxbzd999

Mild to extremely severe-how to judge the severity of thrombocytosis?

Thrombocytosis refers to the high platelet count in the peripheral blood, but some patients have no obvious symptoms. So for patients, how to determine the severity of thrombocytosis based on considerable indicators? Mild to extremely severe-how to judge the severity of thrombocytosis? It is mainly divided by grade. The platelet count is kept within the range of dynamic balance, and the normal value of platelet is 100~300X10^9/L. Mild increase: platelet count ranges from 500 to 700; moderate increase: platelet count range from 700 to 900; severe increase: platelet count range from 900 to 1,000; acute severe increase: platelet count> 1,000 or more. Patients with primary thrombocytopenia last longer, which may be months or years. Some patients have splenomegaly. Bleeding or thrombosis is more common. The platelet count is higher than 1000, and it can also be accompanied by abnormal platelet function. and many more. The higher the number of platelets, the bleeding rate for patients with essential thrombocytosis is much higher than the incidence of thrombosis. Therefore, it is necessary to take timely cell-reducing treatment measures. For more patient communication help, please pay attention to the WeChat public account [thrombocytosis patients association] xxbzd999

Wang Hongxia: What is the high level of red blood cells in the urine test? What needs attention?

Many people will find that their urine red blood cells are high in their physical examination reports, which is also what we often call blood in the urine. Blood in urine is not always visible to the naked eye, and many people don’t understand it well. So, what is going on with high red blood cells in urine test? In normal urine, there are generally no fine cells or only a few red blood cells. The kidney, bladder, or ureter can cause red blood cells to enter the urine, increasing the number of red blood cells in the urine. After centrifugation, if an average of 1 to 2 red blood cells can be seen in each high-power field of the microscope, it is abnormal; if there are more than 3 red blood cells in each high-power field, and the urine has no blood color, it is called microscopic hematuria; The appearance of urine is watery or ocher red, and it is gross hematuria. &nbsp. 1. Physiologically increased&nbsp. The red blood cells and hemoglobin of residents living in plateau areas are often higher than those in plain areas. Drinking too little water or sweating too much, removing too much water can cause temporary blood concentration, causing a slight increase in red blood cells and hemoglobin. Newborns are physiologically increased. 2. Pathologically elevated&nbsp.1. Severe vomiting, diarrhea, excessive sweating, extensive burns, diabetes insipidus, hyperthyroidism crisis, diabetic acidosis, etc., due to excessive loss of water in the plasma, resulting in blood concentration , There will be a significant increase in the amount of red blood cells and hemoglobin. &nbsp.2. Chronic heart disease, cor pulmonale, congenital heart disease, etc. due to tissue hypoxia, the increase of erythropoietin in the blood makes the amount of red blood cells and hemoglobin in the blood show a compensatory increase. &nbsp.3. The patient does not have tissue hypoxia, which is due to the enhanced function of bone marrow to produce red blood cells, but the increase in red blood cells is not required by the body and has no compensatory meaning, and it can also cause high red blood cells. It is more common in certain tumors or kidney diseases, such as nephroblastoma, adrenoid tumor, polycystic kidney, renal artery stenosis, hemangioblastoma, etc. 4. Polycythemia vera is an unexplained blood disease mainly caused by polycythemia. &nbsp. 3. What should I pay attention to when the red blood cells are too high? &nbsp.1. Pay attention to low-salt and low-fat diet, eat more high-vitamin foods; quit smoking and alcohol, avoid eating raw, cold and spicy foods. &nbsp.2, Control the intake of high-protein foods and foods with blood-replenishing function, such as red dates and red beans. 3. Develop good living habits and exercise properly to promote metabolism and enhance resistance. 4. Check regularly and find abnormal situations in time.